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Identification and comparison of Chlamydia psittaci , Legionella and Mycoplasma pneumonia infection

INTRODUCTION: Conventional etiological detection and pathogenic antibody methods make it challenging to identify the atypical pathogens among the community‐acquired pneumonia (CAP). Metagenomic next‐generation sequencing (mNGS) could rapidly detect all potentially infectious diseases and identifies...

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Autores principales: Zhu, Ning, Zhou, Daibing, Yuan, Ruyu, Ruzetuoheti, Yiminniyaze, Li, Jing, Zhang, Xiujuan, Li, Shengqing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214566/
https://www.ncbi.nlm.nih.gov/pubmed/36929690
http://dx.doi.org/10.1111/crj.13603
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author Zhu, Ning
Zhou, Daibing
Yuan, Ruyu
Ruzetuoheti, Yiminniyaze
Li, Jing
Zhang, Xiujuan
Li, Shengqing
author_facet Zhu, Ning
Zhou, Daibing
Yuan, Ruyu
Ruzetuoheti, Yiminniyaze
Li, Jing
Zhang, Xiujuan
Li, Shengqing
author_sort Zhu, Ning
collection PubMed
description INTRODUCTION: Conventional etiological detection and pathogenic antibody methods make it challenging to identify the atypical pathogens among the community‐acquired pneumonia (CAP). Metagenomic next‐generation sequencing (mNGS) could rapidly detect all potentially infectious diseases and identifies novel or potential pathogens. METHODS: Eighteen patients diagnosed with atypical CAP were enrolled in this retrospective study, including nine Chlamydia psittaci pneumonia (C. p), four Legionella pneumonia (L. p) and five Mycoplasma pneumonia (M. p). We simultaneously tested bronchoalveolar lavage fluid (BALF) samples for conventional microbiological methods and mNGS, and blood specimens were analysed. We also collected and compared baseline and clinical characteristics and treatment responses. RESULTS: Patients with C. p and L. p had similar symptoms, including fever, cough, headache, dyspnoea, asthenia, shivering and headache, compared with M. p, whose symptoms were slight. C. p and L. p usually showed multiple lobar distributions with pleural effusion. Serologic testing indicated that L. p had higher levels of white blood cells (WBCs), neutrophils, C‐reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and creatinine compared with M. p and L. p (p < 0.05). However, patients with C. p had lower levels of albumin (p < 0.05), and M. p had a minimum risk of cardiac volume loads (p < 0.05). CD4/CD8 ratio, lymphocytes, aspartate aminotransferase (AST), creatine kinase (CK), cell counting of BALF and coagulation had no difference (p < 0.05). Pathogenic IgM assay showed that 4/5 cases were positive for M. p and no positive detection for C. p and L. p infection. We timely adjusted the antibiotics according to the final mNGS results. Eventually, 16/18 patients recovered fully. Conditions of L. p patients were worse than those of C. p patients, and those of M. p patients were the least. CONCLUSION: Early application of mNGS detection increased the atypical pathogenic identification, improved the prognosis and made up for the deficiency of conventional detection methods.
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spelling pubmed-102145662023-05-27 Identification and comparison of Chlamydia psittaci , Legionella and Mycoplasma pneumonia infection Zhu, Ning Zhou, Daibing Yuan, Ruyu Ruzetuoheti, Yiminniyaze Li, Jing Zhang, Xiujuan Li, Shengqing Clin Respir J Original Articles INTRODUCTION: Conventional etiological detection and pathogenic antibody methods make it challenging to identify the atypical pathogens among the community‐acquired pneumonia (CAP). Metagenomic next‐generation sequencing (mNGS) could rapidly detect all potentially infectious diseases and identifies novel or potential pathogens. METHODS: Eighteen patients diagnosed with atypical CAP were enrolled in this retrospective study, including nine Chlamydia psittaci pneumonia (C. p), four Legionella pneumonia (L. p) and five Mycoplasma pneumonia (M. p). We simultaneously tested bronchoalveolar lavage fluid (BALF) samples for conventional microbiological methods and mNGS, and blood specimens were analysed. We also collected and compared baseline and clinical characteristics and treatment responses. RESULTS: Patients with C. p and L. p had similar symptoms, including fever, cough, headache, dyspnoea, asthenia, shivering and headache, compared with M. p, whose symptoms were slight. C. p and L. p usually showed multiple lobar distributions with pleural effusion. Serologic testing indicated that L. p had higher levels of white blood cells (WBCs), neutrophils, C‐reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and creatinine compared with M. p and L. p (p < 0.05). However, patients with C. p had lower levels of albumin (p < 0.05), and M. p had a minimum risk of cardiac volume loads (p < 0.05). CD4/CD8 ratio, lymphocytes, aspartate aminotransferase (AST), creatine kinase (CK), cell counting of BALF and coagulation had no difference (p < 0.05). Pathogenic IgM assay showed that 4/5 cases were positive for M. p and no positive detection for C. p and L. p infection. We timely adjusted the antibiotics according to the final mNGS results. Eventually, 16/18 patients recovered fully. Conditions of L. p patients were worse than those of C. p patients, and those of M. p patients were the least. CONCLUSION: Early application of mNGS detection increased the atypical pathogenic identification, improved the prognosis and made up for the deficiency of conventional detection methods. John Wiley and Sons Inc. 2023-03-17 /pmc/articles/PMC10214566/ /pubmed/36929690 http://dx.doi.org/10.1111/crj.13603 Text en © 2023 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Zhu, Ning
Zhou, Daibing
Yuan, Ruyu
Ruzetuoheti, Yiminniyaze
Li, Jing
Zhang, Xiujuan
Li, Shengqing
Identification and comparison of Chlamydia psittaci , Legionella and Mycoplasma pneumonia infection
title Identification and comparison of Chlamydia psittaci , Legionella and Mycoplasma pneumonia infection
title_full Identification and comparison of Chlamydia psittaci , Legionella and Mycoplasma pneumonia infection
title_fullStr Identification and comparison of Chlamydia psittaci , Legionella and Mycoplasma pneumonia infection
title_full_unstemmed Identification and comparison of Chlamydia psittaci , Legionella and Mycoplasma pneumonia infection
title_short Identification and comparison of Chlamydia psittaci , Legionella and Mycoplasma pneumonia infection
title_sort identification and comparison of chlamydia psittaci , legionella and mycoplasma pneumonia infection
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214566/
https://www.ncbi.nlm.nih.gov/pubmed/36929690
http://dx.doi.org/10.1111/crj.13603
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